Obesity is a major risk factor for Type I endometrial carcinoma. Which mechanism best explains the increased estrogenic drive to the endometrium in obese postmenopausal women?
- A Increased ovarian androgen production
- B Aromatization of androgens to estrone in peripheral adipose tissue ✓
- C Decreased sex hormone-binding globulin leading to higher free estradiol
- D Direct estrogen secretion by the adrenal glands
Correct answer: B. Aromatization of androgens to estrone in peripheral adipose tissue
Explanation
In postmenopausal women, the primary source of estrogen is the peripheral aromatization of adrenal androgens (androstenedione) to estrone in adipose tissue. Obesity increases this aromatase activity, leading to unopposed estrogen stimulation of the endometrium, which drives hyperplasia and carcinogenesis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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